WRIST COMPLEX. Bones and Joints of the Wrist. Proximal Row of Carpal Bones. Review- testable Scaphoid: Most lateral. Forms floor of anatomical snuff box. Most commonly fractured wrist bone. Fractures may compromise radial artery in snuff box. Articulates with radius.
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Bones and Joints of the Wrist
Forms floor of anatomical snuff box.
Most commonly fractured wrist bone.
Fractures may compromise radial artery in snuff box.
Articulates with radius.
Articulates with radius
Articulates with ulna (via articular (ulnar) disc) during extreme ulnar deviation.
Forms in tendon of the flexor carpi ulnaris
Two concave fossae (lateral and medial)
Only during extreme ulnar deviation
Usually at “waist”
Compromises radial artery in snuffbox
Between proximal and distal rows of carpals and between carpals.
Some flexion and extension.
Radial deviation (abduction).
Especially due to movement of head of capitate in its socket.
Same as for radiocarpal.
Under palmaris longus tendon
None for digits 2-3
Limited for 4
More mobile for 5
Some opposition at MCP 5
Palmar ligaments (pads)
Supratrochlear nodes to:
Lateral axillary nodes.
Infraclavicular nodes to:
Lateral axillary nodes.
Radial and ulnar arteries.
Middle finger is reference
Middle finger has two
First and fifth digits have none.
Flexor digitorum superficialis
Flexor digitorum profundus
Flexor pollicis longus
Deep branch of ulnar nerve (C8, T1).
Recurrent branch of median nerve (C8, T1).
Onto extensor expansions and:
Radial sides of proximal phalanges 2 and 3;
Ulnar sides of proximal phalanges 3 and 4.
Note: digit has two dorsal interossei.
Reference is line through middle finger.
First is sometimes considered part of flexor pollicis brevis.
Supply each digit except third:
Reference is middle finger.
Two on radial side:
Two on ulnar side:
Continuation of ulnar artery.
Continuation of radial artery.
Gives off arteries to the thumb and index finger.
Tendons of the:
Abductor pollicis longus.
Extensor pollicis brevis.
Tendon of the:
Extensor pollicis longus.
Muscular branch to palmaris brevis
Cutaneous to palmar aspect of ulnar side of little finger and adjacent sides of little and ring fingers, including tips and dorsum.
Supplies hypothenar muscles, all interossei, two ulnar side lumbricals, and adductor pollicis.
To thenar muscles and first lumbrical.
Cutaneous to anterior surface of thumb and radial side of index finger.
To second lumbrical.
Cutaneous to adjacent sides of digits 2-4, including nail-bed and finger tips.
Located between the palmar side of the adductor pollicis muscle and the long flexor tendons to the index finger and the thumb.
Located between metacarpals 4-5 and the long flexor tendons to digits 4-5.
Avulsion by long flexor tendon.
Results in hyperflexion of DIP.
Progressive fibrosis of palmar aponeurosis.
Results in marked flexion of fingers at MP joints.
Loss of thumb opposition.
Atrophy of thenar muscles.
Paralysis and atrophy of interossei.
Loss of thumb adduction.
To bases of distal phalanges.
To base of middle phalanx.
Flexion at MCP joint.
Extension at PIP, DIP joints.
Lateral bands will flex the PIP and hyperextend the DIP.